Introduction: What is PCOS?
Polycystic ovary syndrome (PCOS) is an endocrine condition that causes irregular menstrual periods, symptoms of excess androgens (male hormones) which can lead to issues like acne, facial hair growth, and scalp hair loss, and ovaries that appear "polycystic" on pelvic ultrasound. Millions of women struggle with the condition both worldwide in India. Despite this high prevalence, many women do not receive a diagnosis due to a lack of awareness in both the general public and professionals. There is no exact cause for developing PCOS but both genetics and environment can play a key role.
Common Symptoms of PCOS
With PCOS being a hormonal condition, its presentation and severity of symptoms can vary from person to person. Not all symptoms might be present for all individuals, and some people might have PCOS with no symptoms as well. However, some common symptoms are:
1. Irregular Menstrual Cycle:
Women with PCOS often have irregular periods or absent ones. Many women are unlikely to have a period each month.
2. Excess Androgen Levels:
This refers to excess level of male hormones in the system which can lead to an increase in acne, hair loss reflecting male pattern baldness, hair thinning, as well as increased facial or bodily hair (known as hirsutism)
3. Weight Gain:
Sudden increase in weight and difficulty in losing weight is considered a key symptom of PCOS
4. Insulin Resistance:
The above symptom is also linked to greater insulin resistance which is common in PCOS. It can also high blood sugar levels and lead to greater risk of diabetes
5. Fertility Issues:
As women with PCOS are likely to struggle with irregular menstruation, it can also increase their risk of infertility and difficult pregnancies.
6. Mental Health Changes:
Women with PCOS frequently report issues in regulating mood and subsequent mental health difficulties, such as mood swings, anxiety and depression.
ROLE OF STRESS IN PCOS
Stress can play a major role in PCOS as it can exacerbate symptoms. Stress can lead to an uptick in endorphins and secretion of cortisol which can pause hormone production. This pause could be one explanation of an abnormal menstrual cycle. As chronic stress can lead to hormonal fluctuations and disruption of the menstrual cycle, it can worsen the already present symptoms associated with PCOS. The body uses progesterone to make cortisol to respond to the stress you’re experiencing, so the higher levels of cortisol could lead to lower levels of progesterone, an explanation for the slow or reduced periods.
These raised cortisol levels can lead to a difficulty of the body to regulate its blood sugar levels, which can worsen metabolic and weight related issues that come about due to PCOS. These levels can also cause delayed ovulation which might be an explanation behind the infertility issues that women with PCOS face.
Chronic stress and the resulting changes can also lead to an increase in the inflammation in the body and can worsen symptoms of acne and fatigue. The already present issues of mental health which are associated with PCOS may worsen due to the elevated levels of chronic stress. The mental health of women with PCOS may also worsen due to the exacerbated symptoms brought about by stress, with stress acting as a double edged sword. This is particularly pertinent as women with PCOS also tend to be more stressed than women without PCOS.
Managing stress levels for managing your PCOS symptoms is key. People could try meditation, mindfulness, regular exercise, avoiding triggers, and accessing therapeutic and emotional support.
If it’s difficult to speak to a professional or friend about your difficulties, you could also try speaking to Healo , our AI mental health chatbot which could offer an anonymous way of discussing your emotional struggles.
HORMONES AND PCOS
Hormones can play a very significant role in mental health, and keeping in mind the issues with hormonal imbalance present in PCOS, it can play a major role in the emotional well-being of women with PCOS. Different hormones can influence mental health in different ways. We’ve already discussed the hormones that can be elevated in PCOS, and these elevated levels can impact mental health in significant ways.
- Androgens: Elevated androgen levels can lead to an increase in aggression, anxiety and mood swings, commonly found in women with PCOS.
- Insulin and Blood Sugar Levels: The unstable blood sugar levels brought about by the Insulin resistance found in PCOS can increase fatigue and irritability.
- Cortisol: In addition to its other impacts, high cortisol levels can lead to worsened symptoms of anxiety and depression.
- Progesterone and Estrogen: Hormonal imbalances in these can lead to fluctuating levels of serotonin and dopamine, which play a key role in regulating mood and emotional stability.
Another key note is that while PCOS and premenstrual dysphoric disorder (PMDD) are distinct disorders, PCOS can worsen the risk of PMDD. PMDD is a severe form of PMS that may cause extreme mood swings, depression, and anxiety before menstruation. You can read more about PMDD here.
COMMON TRENDS IN PCOS AND MENTAL HEALTH
A key feature of PCOS and women is their difficulties in mental health. Many women with PCOS face difficulties with their mental health, whether as anxiety, depression, mood swings, increased risk of developing an eating disorder, and more. We’ve already discussed how stress in women with PCOS can worsen their mental health. However, it is also an undeniable fact that PCOS as a condition itself is likely to lead to poor mental health and increased stress levels.
The symptoms of PCOS, with the increase in acne, facial hair, weight gain, hair loss, etc can significantly impact women’s self-esteem and subsequently worsen their mental health. Worrying about these symptoms will lead to an increase in stress which will further worsen the symptoms. When these women are struggling with low self-esteem or stress, they may find themselves with increased insecurity, sleep issues, or struggles with food, all of which could play a major role in negative mental health outcomes.
Another key note to keep in mind is that PCOS is a chronic condition with no cure, living with a chronic illness can itself be a major factor negatively influencing mental health. When we keep in mind the issues with infertility that PCOS can cause, the resulting mental health effects become even more intense. Fertility can be such an important part of self-identity for some women that the difficulties caused by PCOS, not to mention the societal pressures and condemnation surrounding infertility can greatly impact women’s mental health.
CONCLUSION
As we’ve explored, PCOS is more than just a hormonal or reproductive condition, it can impact all aspects of our life, particularly in mental health. While PCOS is a chronic condition with no cure, there are still things we can do to manage the symptoms and thus, improve outcomes. Some symptoms may be improved through lifestyle changes, medication, fertility treatments, and more. While managing the physical symptoms may ease the emotional symptoms automatically, it is also important to address them directly.
Addressing these symptoms through stress-management, therapeutic and healthy coping skills, reaching out to therapists or support groups for support could also help ease the situation. Finding the right professional who will hear you and support you is important, and you shouldn’t give up on finding the right support.
